RAPTIVA for Plaque Psoriasis

Results with RAPTIVA

RAPTIVA is an exciting option for the treatment of chronic moderate to severe Plaque Psoriasis.

  • Baseline

  • After 3 months on RAPTIVA

  • BSA Percent Over Time


Individual results may vary


RALPH B.*, sustained clearing for 36 months with monotherapy

  • Patient overview

    • 28-year-old Caucasian male
    • 12-year history of plaque psoriasis
    • Comorbidities include diabetes, hypercholesterolemia, and psoriatic arthritis

    Prior treatments

    • No history of systemic therapy

  • Clinical course on RAPTIVA

    (RAPTIVA 1 mg/kg SC weekly, after initial 0.7 mg/kg conditioning dose)

    • Baseline psoriasis BSA 18%
    • At 3 months, BSA improved to 3%
    • At 6 months, BSA improved to 0%
    • Patient has maintained improvement with RAPTIVA therapy for 36 months

This case study shows one patient's response to treatment with RAPTIVA for a given period of time. *Name has been changed and tattoo covered to protect patient's privacy. **Patient received 2 mg/kg SC weekly for 11 weeks, allowed per study protocol. In clinical trials, RAPTIVA 2 mg/kg was not superior to RAPTIVA 1 mg/kg. Patient case information provided by Craig Leonardi, MD.

Clinical Data

  • RAPTIVA has been:
  • Studied in >4,000 patients enrolled in 14 clinical trials
  • Longest continuous treatment trial (3-year RAPTIVA study) completed in psoriasis patients receiving a biologic that shows a maintenance of response over time
  • More than 5,635 US dermatologists have prescribed RAPTIVA
  • Used by >43,200 patients worldwide

This 36-month study is the longest continuous trial in chronic plaque psoriasis patients receiving a biologic agent

Efficacy in open-label study over 36 months (ITT analysis)1

* During the initial 3-month treatment period, enrolled patients received SC efalizumab 2 mg/kg/wk. After this 3-month period, patients who achieved at least a 50% improvement in baseline PASI or sPGA grading of Clear, Minimal, or Mild were eligible to enter the maintenance portion of the study.

† Patients were transitioning out of the study during the last 3 months.


  • Improvement in PASI response over 36 months (ITT)1
  • 41% of patients reached PASI 75 by 3 months; 45% by 36 months
  • 13% of patients reached PASI 90 at 3 months; 25% at 36 months

A randomized, double-blind, parallel-group, placebo-controlled, multicenter study in which patients received 1 mg/kg/wk RAPTIVA (n = 369) or placebo (n = 187) for 3 months. Patients on RAPTIVA who completed the initial treatment were allowed to enter an open-label extension trial at the same dose for an additional 3 months.


Important Safety Information

RAPTIVA is indicated for the treatment of adult patients (18 years or older) with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

  • The most serious adverse reactions observed during treatment with RAPTIVA® [efalizumab] were serious infections, malignancies, thrombocytopenia, hemolytic anemia, arthritis events, and psoriasis worsening and variants.
  • RAPTIVA is an immunosuppressive agent. Many immunosuppressive agents have the potential to increase the risk of infection, reactivate latent, chronic infections, or increase the risk of malignancy. Patients receiving other immunosuppressive agents should not receive concurrent therapy with RAPTIVA.
  • Serious infections requiring hospitalization occurred in 0.3% of RAPTIVA patients during clinical trials, and additional serious infections have been reported during postmarketing surveillance. RAPTIVA should not be administered to patients with clinically important infections. If a patient develops a serious infection, RAPTIVA should be discontinued.
  • The role of RAPTIVA in the development of malignancy is not known. In clinical trials, the overall incidence of malignancies was 1.8 per 100 patient-years for RAPTIVA-treated patients vs 1.6 per 100 patient-years for placebo-treated patients. Caution should be exercised when considering the use of RAPTIVA in patients at high risk for malignancy. If a patient develops a malignancy, RAPTIVA should be discontinued.
  • Infrequent cases (0.3%) of immune-mediated thrombocytopenia were observed during clinical trials and reports of severe thrombocytopenia have been received postmarketing; therefore, platelet monitoring is recommended. Physicians should follow patients for signs and symptoms of thrombocytopenia, and RAPTIVA should be discontinued if thrombocytopenia develops.
  • Reports of immune-mediated hemolytic anemia, some serious, diagnosed 4-6 months after the start of RAPTIVA treatment have been received. RAPTIVA should be discontinued if hemolytic anemia occurs.
  • Worsening of psoriasis can occur during or after treatment with RAPTIVA. During clinical studies, 19 of 2589 (0.7%) RAPTIVA-treated patients had serious worsening of psoriasis during treatment (n = 5, 0.2%) or after discontinuation of RAPTIVA (n = 14, 0.5%). Some patients required hospitalization (n = 17, 0.7%).Patients, including those not responding to RAPTIVA treatment, should be closely observed following discontinuation of RAPTIVA and appropriate psoriasis treatment instituted as necessary.
  • Infrequent new onset or recurrent severe arthritis events, including psoriatic arthritis events, have been reported in clinical trials and postmarketing. These arthritis events began while on treatment or following discontinuation of RAPTIVA and were uncommonly associated with flare of psoriasis. Patients improved after discontinuation of RAPTIVA with or without anti-arthritis therapy.
  • The safety and efficacy of vaccines administered to patients being treated with RAPTIVA have not been studied. A cellular, live, and live-attenuated vaccines should not be administered during RAPTIVA treatment.
  • The most common adverse reactions associated with RAPTIVA were a symptom complex that included headache, chills, fever, nausea, and myalgia within 48 hours following the first 2 injections. These events were largely mild to moderate when a first dose of 0.7 mg/kg was given. Less than 1% of patients discontinued RAPTIVA treatment because of these adverse events.
  • Female patients should also be advised to notify their physicians if they become pregnant while taking RAPTIVA(or within 6 weeks of discontinuing RAPTIVA) and be advised of the existence of and encouraged to enroll in the RAPTIVA Pregnancy Registry by calling 1-877-RAPTIVA(1-877-727-8482).

References:

  1. Gottlieb AB, Gordon KB, Hamilton TK, et al. Maintenance of efficacy and safety with continuous efalizumab therapy in patients with moderate to severe chronic plaque psoriasis: final phase IIIb study results. Presented at 2005 AAD; February 18-23, 2005.
  2. Data on file,Genentech,Inc.


RAPTIVA (efalizumab)

Starting Patients on RAPTIVA Therapy

Additional Resources